Biliary Tract Disease

Question 1

How do we get gallstones

Answer 1

Abnormal bile composition 
Bile stasis
Infection 
Excess cholesterol
Excess bilirubin

Question 2

Biliary Colic

Answer 2

1. Stone impacts in cystic duct
2. Gradual build up pain in RUQ
3. Radiates to back/shoulder
4. May last 2-6 hours
5. Indigestion, nausea

Question 3

Diagnosis of gallstones

Answer 3

Ultrasound
CT scan
MRCP/ERCP
HIDA
EUS

Question 4

Treat biliary colic

Answer 4

Pain killers
Low fat diet/loose wight
Observe 3-6 months

Question 5

Acute cholecystitis

Answer 5

Inflammation in gall bladder (obstruction of cystic duct)

Initially sterile, then becomes infected

Question 6

Treatment of acute cholecystitis

Answer 6

IV antibiotics and IV fluids
Nil by mouth
Urgent cholecystectomy